SIDS and Safety
Reducing the risk of SIDS:
All new parents should receive information about SIDS or SUDI (Sudden Infant Death Syndrome or Sudden Unexpected Death in Infancy) before or just after their baby is born. All official national guidelines emphasise similar points for reducing the risk of SIDS/SUDI:
- Place your baby on its back to sleep, in a safe space with a firm flat mattress, in a room with you
- Do not smoke in pregnancy or let anyone smoke in the same room as your baby
- Do not share a bed with your baby if you have been drinking alcohol, taking drugs, are a smoker, or your baby was born prematurely
- Never sleep with your baby on a sofa or armchair
- Do not let your baby get too hot or too cold, and keep your baby’s head uncovered
- Breastfeed your baby
Recent research has developed a potential model of three types of factors that may put a baby at a higher risk of SIDS. The first factor describes vulnerabilities that the baby is born with, like a premature birth or prenatal exposure to harmful chemicals (for example cigarette smoke or drugs). The second factor is the stage of development the baby is in. The average age for the critical developmental period for infants appears to be 2 – 4 months of age, the age when most SIDS deaths occur. The third factor are outside factors, like a parent smoking, tummy sleeping, restricted breathing or a covered face when sleeping (because of a blanket, or because the baby’s head got stuck somewhere on the bed), and overheating (for example too much bedding in winter). Research has also found that 75% of day-time SIDS occur when the baby is sleeping in a room without their mother/caregiver present. More information about the Triple Risk Model can be found here.
Although most new parents think that they will never sleep with their baby, research shows that many do so for various reasons. On any given night a fifth of all UK babies spend at least part of the night sleeping with one or both of their parents. ( The prevalence and characteristics associated with parent-infant bed-sharing in England. Blair & Ball, 2004 ) In addition to the increased risk of SIDS that is associated with bed-sharing with a smoker (or being smoke-exposed during pregnancy), or with a recent alcohol or drug user, there is also a risk of accidents when adults sleep on the same surface as a baby. In order to reduce the chance of accidents it is important to be informed about bed-sharing safety, whether or not you intend to do it, as we sometimes fall asleep with our babies when we don’t mean to – especially during night-time feeds.
Falling asleep with a baby on a sofa or an arm-chair is associated with wedging and compression accidents where babies are trapped between the furniture and their parent’s body. Placing a baby alone on an adult bed is associated with accidents where babies fall and become trapped between the bed and a wall, or between the bars of an open headboard. Think about how to safety-proof your bed if you might possibly bed-share with your baby. La Leche League produces the Safe Sleep Seven information sheet with safety guidance for bed-sharing. Information about bed-sharing safety is also available on the NCT website, and the UNICEF/Lullaby Trust ‘Sharing a Bed with your Baby‘ leaflet is still available on many websites, although now replaced by the new ‘Caring for your baby at night‘ leaflet.
All new cots sold in the UK must meet European Safety Standards and should carry the British Standards Institution (BSI) number BS EN 716:2008, which indicates that they comply with the required safety standards. However hand-me-down or second-hand products may be defective, or produced before current safety standards were implemented. The Consumer’s Association provides guidelines regarding safety of new and second-hand cots. In the US drop-sided cots have been banned since June 2011 due to infant deaths and product recalls; no such ban has been proposed for Europe.
Research has not found any link between mattresses and SIDS. The Lullaby Trust recommend cot mattresses should be clean and dry with no tears, cracks or holes, and if possible purchase a new mattress for each baby. The mattress should fit the cot without gaps. The Consumer’s Association provides guidance on these products, as does NHS Choices. Think about where you place your baby’s cot and ensure it is away from radiators, curtains, and hanging cords.